Looking like a doctor

I do not like to shave.

There are multiple reasons for this. I do not like the extra time it takes in the morning. Too often, I wind up with one or two cuts. I happen to like a little bit of stubble. My attitude toward shaving softened somewhat 2 years ago when my wife got me a wonderful gift – an old-fashioned shaving kit. I now use shaving soap with the cool shaving brush instead of squirting lotion out of a can. The process has become more fun, but I only shave slightly more frequently than I did before the gift.

Why am I writing about this? Not too long ago, a JAMA article examined the relationship between physician grooming and attire and patient/family perceptions of those physicians. The study was done in an intensive care unit (ICU) setting and demonstrated that neat grooming, professional dress and wearing a name tag were important considerations on the part of respondents. More than 300 family members of critically ill patients were asked to rate the importance of ten factors related to physician appearance. They were also showed four photos of physicians in various styles of dress and asked to select the best physician from those photos.

In rating the physician-related factors, nearly 80% of family members thought an easy to read name tag was important. Neat grooming was of major importance to 65% of those surveyed, while 59% wanted to see professional attire. In this portion of the study, only 32% felt a while coat was important. However, when presented with the various photographs of physicians, 52% of respondents thought the physician wearing the white coat was the best physician.

I have several inflection points on my growth curve pertaining to grooming and dress as a physician. My first occurred as a senior resident in the ICU. I felt I had earned a certain amount of respect and latitude based upon my performance as an intern. Thus, when I was on call during the weekend, I would wear jeans with a scrub top instead of just plain scrubs. One of the first times I did this, a nurse literally berated me for wearing jeans. I was told it was not a professional look – my patients deserved better.

I took her advice under consideration and ignored it. I continued to wear jeans (with a nice button down shirt, sometimes with a sweater) as an attending when I was doing weekend rounds. Several years ago, I had risen to positions of some prominence within my former hospital. I thought of that conversation with the nurse, and it dawned on me that I should always look the part of a physician – especially a physician leader. The jeans went back to the closet, only to be worn outside of work.

The second inflection point is courtesy of my former CEO. During the time we worked together, he was always meticulously dressed and groomed. One day, he related an incident that occurred to him during his residency. He was post call and, in the interest of several extra minutes of sleep, had neglected to shave. He had his continuity clinic that day and one of his favorite patients – a woman in her 70s – was on his schedule. On that day, she had brought her grandson with her to the visit. She hoped to inspire the grandson to pursue something more with his life.

After the visit, she asked her grandson to wait outside the exam room for a moment. After he stepped out of the room, she proceeded to inform my former CEO that she expected more of him – that he should look like a doctor at all times. She brought her grandson to see her physician and not an unshaven individual who – in her mind – did not look the part. It was an important lesson for him and clearly changed his attitude toward dress and grooming.

This study is a reminder of the importance of our appearance as physicians and health care providers. As that ICU nurse pointed out to me many years ago, our patients deserve our best – let us give it to them.

Dr. Pistoria is chief of hospital medicine at Coordinated Health in Bethlehem, Pa. He believes that the best care is always personal.

I do not like to shave.

There are multiple reasons for this. I do not like the extra time it takes in the morning. Too often, I wind up with one or two cuts. I happen to like a little bit of stubble. My attitude toward shaving softened somewhat 2 years ago when my wife got me a wonderful gift – an old-fashioned shaving kit. I now use shaving soap with the cool shaving brush instead of squirting lotion out of a can. The process has become more fun, but I only shave slightly more frequently than I did before the gift.

Why am I writing about this? Not too long ago, a JAMA article examined the relationship between physician grooming and attire and patient/family perceptions of those physicians. The study was done in an intensive care unit (ICU) setting and demonstrated that neat grooming, professional dress and wearing a name tag were important considerations on the part of respondents. More than 300 family members of critically ill patients were asked to rate the importance of ten factors related to physician appearance. They were also showed four photos of physicians in various styles of dress and asked to select the best physician from those photos.

In rating the physician-related factors, nearly 80% of family members thought an easy to read name tag was important. Neat grooming was of major importance to 65% of those surveyed, while 59% wanted to see professional attire. In this portion of the study, only 32% felt a while coat was important. However, when presented with the various photographs of physicians, 52% of respondents thought the physician wearing the white coat was the best physician.

I have several inflection points on my growth curve pertaining to grooming and dress as a physician. My first occurred as a senior resident in the ICU. I felt I had earned a certain amount of respect and latitude based upon my performance as an intern. Thus, when I was on call during the weekend, I would wear jeans with a scrub top instead of just plain scrubs. One of the first times I did this, a nurse literally berated me for wearing jeans. I was told it was not a professional look – my patients deserved better.

I took her advice under consideration and ignored it. I continued to wear jeans (with a nice button down shirt, sometimes with a sweater) as an attending when I was doing weekend rounds. Several years ago, I had risen to positions of some prominence within my former hospital. I thought of that conversation with the nurse, and it dawned on me that I should always look the part of a physician – especially a physician leader. The jeans went back to the closet, only to be worn outside of work.

The second inflection point is courtesy of my former CEO. During the time we worked together, he was always meticulously dressed and groomed. One day, he related an incident that occurred to him during his residency. He was post call and, in the interest of several extra minutes of sleep, had neglected to shave. He had his continuity clinic that day and one of his favorite patients – a woman in her 70s – was on his schedule. On that day, she had brought her grandson with her to the visit. She hoped to inspire the grandson to pursue something more with his life.

After the visit, she asked her grandson to wait outside the exam room for a moment. After he stepped out of the room, she proceeded to inform my former CEO that she expected more of him – that he should look like a doctor at all times. She brought her grandson to see her physician and not an unshaven individual who – in her mind – did not look the part. It was an important lesson for him and clearly changed his attitude toward dress and grooming.

This study is a reminder of the importance of our appearance as physicians and health care providers. As that ICU nurse pointed out to me many years ago, our patients deserve our best – let us give it to them.

Dr. Pistoria is chief of hospital medicine at Coordinated Health in Bethlehem, Pa. He believes that the best care is always personal.

I do not like to shave.

There are multiple reasons for this. I do not like the extra time it takes in the morning. Too often, I wind up with one or two cuts. I happen to like a little bit of stubble. My attitude toward shaving softened somewhat 2 years ago when my wife got me a wonderful gift – an old-fashioned shaving kit. I now use shaving soap with the cool shaving brush instead of squirting lotion out of a can. The process has become more fun, but I only shave slightly more frequently than I did before the gift.

Why am I writing about this? Not too long ago, a JAMA article examined the relationship between physician grooming and attire and patient/family perceptions of those physicians. The study was done in an intensive care unit (ICU) setting and demonstrated that neat grooming, professional dress and wearing a name tag were important considerations on the part of respondents. More than 300 family members of critically ill patients were asked to rate the importance of ten factors related to physician appearance. They were also showed four photos of physicians in various styles of dress and asked to select the best physician from those photos.

In rating the physician-related factors, nearly 80% of family members thought an easy to read name tag was important. Neat grooming was of major importance to 65% of those surveyed, while 59% wanted to see professional attire. In this portion of the study, only 32% felt a while coat was important. However, when presented with the various photographs of physicians, 52% of respondents thought the physician wearing the white coat was the best physician.

I have several inflection points on my growth curve pertaining to grooming and dress as a physician. My first occurred as a senior resident in the ICU. I felt I had earned a certain amount of respect and latitude based upon my performance as an intern. Thus, when I was on call during the weekend, I would wear jeans with a scrub top instead of just plain scrubs. One of the first times I did this, a nurse literally berated me for wearing jeans. I was told it was not a professional look – my patients deserved better.

I took her advice under consideration and ignored it. I continued to wear jeans (with a nice button down shirt, sometimes with a sweater) as an attending when I was doing weekend rounds. Several years ago, I had risen to positions of some prominence within my former hospital. I thought of that conversation with the nurse, and it dawned on me that I should always look the part of a physician – especially a physician leader. The jeans went back to the closet, only to be worn outside of work.

The second inflection point is courtesy of my former CEO. During the time we worked together, he was always meticulously dressed and groomed. One day, he related an incident that occurred to him during his residency. He was post call and, in the interest of several extra minutes of sleep, had neglected to shave. He had his continuity clinic that day and one of his favorite patients – a woman in her 70s – was on his schedule. On that day, she had brought her grandson with her to the visit. She hoped to inspire the grandson to pursue something more with his life.

After the visit, she asked her grandson to wait outside the exam room for a moment. After he stepped out of the room, she proceeded to inform my former CEO that she expected more of him – that he should look like a doctor at all times. She brought her grandson to see her physician and not an unshaven individual who – in her mind – did not look the part. It was an important lesson for him and clearly changed his attitude toward dress and grooming.

This study is a reminder of the importance of our appearance as physicians and health care providers. As that ICU nurse pointed out to me many years ago, our patients deserve our best – let us give it to them.

Dr. Pistoria is chief of hospital medicine at Coordinated Health in Bethlehem, Pa. He believes that the best care is always personal.